audiology externship handbookmed-fom-audiology.sites.olt.ubc.ca/files/2016/07/audi...audiology...
TRANSCRIPT
UBC School of Audiology and
Speech Sciences
Audiology Externship Handbook
www.audiospeech.ubc.ca
©School of Audiology and Speech Sciences, 2017
UBC School of Audiology and Speech Sciences 2
Dear Clinical Educators:
We would like to welcome you warmly and thank you for joining the dedicated group of Clinical Educators who provide learning opportunities for our students.
Who we are:
The Clinical Teaching and Coordinator Team (CTCT) will be your primary source of support for the duration of your role as Clinical Educators within the School of Audiology and Speech Sciences (SASS).
The Audiology team members are:
Sasha Brown RAUD, Clinical Coordinator [email protected] Darlene Hicks RAUD, Clinical Coordinator [email protected] Jamie Lee Baudru, Clinical Program Assistant [email protected]
Our promise to you:
We are committed to providing you with rewarding experiences and meaningful outcomes. Through the Clinical Educators Development Program, we aim to provide:
1. Clarity: ensuring that all stakeholders (e.g. the School, the Clinical Coordinators, the Clinical
Educators and the Students) roles and responsibilities are clear and concise, and that expectations of the various stakeholders are consistent and explicit.
2. Quality: ensuring that our students are prepared for their externships and their role within your work setting, while also ensuring that you are supported through the continuing education opportunities provided by Clinical Teaching and Coordinator Team.
3. Culture: ensuring a sense of community through dedicated orientations and fostering
relationships through ongoing communications, webinars and workshops.
Our thanks:
Our students are excited about their clinical externships and look forward to them with eager anticipation. It is through your guidance that students learn to put their knowledge into practice, to reflect on their successes and their setbacks, and to grow as young professionals. We thank you for your commitment to the next generation of speech-language pathologists and audiologists.
Sincerely,
The Clinical Teaching and Coordinator Team School of Audiology & Speech Sciences University of British Columbia
UBC School of Audiology and Speech Sciences 3
Contents Externship Overview ......................................................................................................................................... 4
Typical Schedule and Goals ........................................................................................................................ 5
Externships Overview: Roles & Responsibilities ...................................................................................... 6
What Counts as a Clinical Hour? ................................................................................................................. 10
What are the Procedures for Absences ...................................................................................................... 11
Clinical Educator Preparation .......................................................................................................................... 12
Clinical Educator Role ............................................................................................................................... 13
The Continuum of Learning ...................................................................................................................... 15
Setting Expectations ................................................................................................................................... 16
Creating Learning Environments ................................................................................................................ 17
Clinical Educator Continuing Development ................................................................................................ 18
Student Clinical Skill Development .................................................................................................................. 20
Collaborative Practice: .............................................................................................................................. 21
Clinical Reasoning ..................................................................................................................................... 22
Feedback Conversation ............................................................................................................................... 24
Evaluations .................................................................................................................................................. 26
The Challenging Learning Situation - What to do and when ................................................................. 28
Facilitating Student Reflection: Some ideas ............................................................................................ 29
Forms .............................................................................................................................................................. 30
MIDTERM EVALUATION .............................................................................................................................. 31
EVALUATION OF CLINICAL SKILLS IN AUDIOLOGY ...................................................................................... 34
Faculty of Medicine Univ ........................................................................................................................ 36
Summary of Clinical Practice Hours ...................................................................................................... 45
LOOKING AHEAD ......................................................................................................................................... 46
Clinical Skills Summary Form - Audiology ................................................................................................... 47
Additional Resources ....................................................................................................................................... 51
Curriculum Overview, Audiology Students ............................................................................................. 52
Getting set up: Who does what when? ...................................................................................................... 55
Student post-session analysis ..................................................................................................................... 56
Clinical Feedback Form............................................................................................................................. 57
UBC School of Audiology and Speech Sciences 4
Externship Overview Typical Schedule and Goals
Externship Overview: Roles and Responsibilities
What counts as a clinical hour?
Process for absences
UBC School of Audiology and Speech Sciences 5
Typical Schedule and Goals
Externship 1: May — June, 7 weeks Externship 2: July — August, 7 weeks Externship 3: January — February, 6 weeks Externship 4: February — April, 7 weeks The first externship provides students with their first intensive opportunity to link classroom material to the clinical world. There are several areas of clinical skill that students should begin to develop at this point in their training:
basic assessment procedures specific to the setting planning and implementing treatment for typical clients understanding of the role of the audiologist self-evaluation of their interactions with clients, families and other professionals observing and describing clients' communication behaviour observing and differentiating techniques used by the Clinical Educator developing an awareness of the client as a whole person
Externships 2 through 4 run from 6-8 weeks in length and allow the students to continue to build on their clinical skills and apply their classroom knowledge to the clinical setting. Students will start with observation and shared sessions but are expected to move quickly into more independence in the clinic. Rate of progress will depend on individual student’s strengths and past experiences. At the end of the 3rd and 4th externship, each student should able to handle the typical clinical caseload at a site with coaching required from the Clinical Educator only for more specialized clinical cases.
At Graduation: Our goal is to graduate clinicians who....
have the knowledge base, clinical skills and personal characteristics necessary to be competent audiologists.
can translate classroom knowledge into clinical skills. have the appropriate number of clinical hours to meet SAC certification requirements
have the ability to work as a generalist with preschool children, school age children or adults in diagnostic and amplification settings.
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Externships Overview: Roles & Responsibilities
Timeline UBC Clinical Coordinator Roles & Responsibilities
Clinician Roles & Responsibilities
Student Roles & Responsibilities
Pre- Extern-ship Refer also to “Getting Set Up”
Coordinates externship locations
Prepares student for clinical experience
Provides orientation to new Clinical Educators
Reviews Student Profile and student’s letter of introduction.
Provide student(s) with readings and/or information re: your clinical setting.
Plans orientation for student
Informs colleagues of upcoming students
Sends letter of introduction no later than one month pre- externship Prepares for the clinic setting by acquiring info re: site, reviewing assessments, class notes, where applicable, and any other relevant sources of information Prepares “Summary of Clinical Skills” (for second, third or fourth externship)
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Timeline UBC Clinical Coordinator Roles & Responsibilities
Clinician Roles & Responsibilities
Student Roles & Responsibilities
Week 1 Checks in with Clinical Educator and student via email or phone
Orientation: Provide introductions to team members and site orientation including health & safety practices and emergency procedures. Determine what experience the student has had prior to this externship so scaffolding support can be implemented.
Discuss “Summary of Clinical Skills”, which will be prepared by student prior to externship (can skip for student’s first externship) See sample.
Sets expectations: Preparation required by student
Administration procedures (referral
process, record keeping, confidentiality)
Hours Dress Clientele Culture of Organization Meetings
Feedback/discussion schedule Procedure or timing of midterm and final
evaluations Refer to “Setting Expectations”
Completes Occupational Health and Safety survey and any other placement-specific forms Presents or discusses:
Goals for Placement Personal Learning Objectives Preferred learning style Feedback preferences Any prior clinical experiences
Participates in Guided Observation. Discusses same with Clinical Educator.
By end of week 1, student will be participating in 1.5 to 2 clinical hours* per day. See “what counts as a clinical hour?”
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Timeline UBC Clinical Coordinator Roles & Responsibilities
Clinician Roles & Responsibilities
Student Roles & Responsibilities
Week 2- midterm
UBC Clinical Coordinator aims to provide ongoing support and mentorship to both CE and student throughout externship
Model techniques, explicit description of what you are doing and why you are doing what you are doing Regular meetings with student(s) for updates and provision of feedback Active observations of student(s) Shared participation
Increased student participation is expected over the course of these weeks in consultation with their Clinical Educator. Collaborative practice between clinician and student continues and support to student can be reduced as they become more independent.
Observations continue, student begins to assume more responsibility
By end of week 2, student will be participating 2 to 3 clinical hours* per day. By end of week 3, student will be participating 3-4 clinical hours* per day.
Midterm Reviews Midterm Evaluation
Connects with CE and student via email or phone.
If any issues are highlighted, Clinical Coordinator will respond accordingly.
Midterm Evaluation is completed with the student and faxed to Clinical Coordinator, including Action Plan See Evaluations
Clinical Coordinator to be contacted with any questions or concerns
Set goals for remainder of placement
Midterm Evaluation is completed with CE
Following evaluation, review and modify learning objectives and learning plan Set goals with help of CE Clinical Coordinator to be contacted with any questions or concerns
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Timeline UBC Clinical Coordinator Roles & Responsibilities
Clinician Roles & Responsibilities
Student Roles & Responsibilities
Midterm – Final Week
Supports are available for any comments or concerns from both the CE and student
Actively observes student - Some indirect supervision may be appropriate at this time
Modeling continues – at this stage expect students to begin explaining to you why you’re doing what you’re doing Regular meetings with students for updates and provision of feedback
*Increased independent self-initiated student participation is expected throughout these weeks, but student always discusses findings/recommendations before client leaves. Other learning opportunities might occur, such as observation of other team members or surgery. Student may present at in-service or case-conference
Student assumes more responsibility for clients. Further development of clinical reasoning skills (clear and concise rationale) Student-initiated collaboration for any new clients and/or clinical scenarios
By end of week 4, student will be participating 4-5 clinical hours* per day. Weeks 5-8, student will be participating 4-6 clinical hours* per day.
Final Week Complete Final Evaluation with student based on student performance during last 20% of placement. Fax or Mail to Clinical Coordinator See Evaluations
Complete hours form and ask CE to sign off.
Post- externship Clinical Coordinator will collect feedback from Clinical Educators and students.
Provide any feedback to Clinical Coordinator Provide any feedback to Clinical Coordinator and/or Clinical Educator
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What Counts as a Clinical Hour?
*What counts as a clinical hour?
Students are required to have 350 supervised hours of practice for registration with the College of Speech and Hearing Health Professionals of BC (CSHHPBC).
What can be counted: What cannot be counted:
Direct contact with clients
Active involvement
Specific observations made, independently or as guided by you
Any case discussions, including the use of documentation to enhance or
inform the discussion
Report writing
Session preparation
Whose responsibility is it to keep track of these hours?
Students keep track of their hours and will ask you to sign the bottom of the form at the end of the placement.
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What are the Procedures for Absences
A. Absences for health reasons: B. Absences for educational reasons: C. Absences for personal reasons:
It is typical that a student might miss one or two days of an externship due to illness, doctor’s appointment, etc.
It is important, however, that the student have ample opportunity to develop clinical skills over the full externship period. If a student misses more than 10% of the externship (e.g. 4 days of a 7 or 8 week externship; or 3 days of a 5 or 6 week externship), the time must be made up.
Professional educational opportunities such as professional conferences also provide important learning experiences for students. However, this must be balanced against valuable clinical time.
Students wishing to attend a professional educational event, not offered as part of their externship, must review this request with their Clinical Coordinator PRIOR to discussion with Clinical Educator. Approval will be considered on a case-by-case basis.
For any other absence, students must review this request with their Clinical Coordinator PRIOR to discussing with their Clinical Educator. Approval will be considered on a case-by-case basis.
Any days for personal leave will have to be made up.
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Clinical Educator Preparation Clinical Educator Role
The Continuum of Learning
Setting Expectations
Creating Learning Environments
Clinical Educator Continuing Development
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Clinical Educator Role
1. What are you expected to teach students throughout their externships? When students leave the Audiology Program, the expectation is that they are Entry-Level Ready
generalists with a broad range of skills that they can hone in on and specialize, depending on their
preferred clinical population.
To teach and develop students':
Interpersonal & Professional Skills:
Provide students with opportunities to build rapport with clients and family members.
Encourage students to reflect on and self-evaluate their knowledge, skills and attitude throughout the placement
Provide opportunities for discussions re: ethical and/or culturally sensitive issues within caseload
Provide a safe environment for students to examine their own personal preferences and biases and the impact such
preferences and/or biases may have on their clinical encounters
Facilitate students to develop their time management skills including preparation for sessions
Facilitate students to develop their professional clinical identity.
Encourage effective collaboration
Assessment Skills:
Provide exposure to assessment procedures, as well as providing opportunities for conducting assessments specific to
clientele and setting.
Provide opportunities for the development of critical thinking – development of assessment plan and rationale for same
Treatment Skills:
Provide students with the opportunities for planning and performing appropriate interventions with sound rationale
Encourage students to develop their skills in giving feedback to clients and their families.
Provide opportunities for the student to understand the scope of practice e.g. their role as educator, facilitator,
counsellor etc.
Communication Skills:
Provide opportunities for the development of oral and written communication skills with a range of individuals,
including but not limited to health professionals, family and clients
Provide opportunities for students to collaborate with other health professionals
In order for students to have the:
1. necessary knowledge base, clinical skills and personal characteristics to be competent audiologists 2. ability to work as a generalist with preschool children, school-aged children and/or adults in diagnostic or
amplification settings 3. ability to translate classroom knowledge into clinical skills 4. requisite number of clinical hours to meet BC provincial requirements
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2. How are you expected to bring a student from Novice to Entry-Level Ready?
To develop from novice to entry-level ready, the student will go through a series of stages as a
learner. With every new skill requires the student will move from one stage to the next.
Some skills may be more advanced than others, depending on the student’s strengths and challenges.
It is important to note that students who are entry-level ready are mostly likely to demonstrate skills
at the conscious competent level. They are not experts yet – and won’t be without many more years
of practice under their belt!
The table below outlines the 4 stages, and the characteristics associated with each stage. The table
also provides strategies that you can employ to guide the student through each phase of learning.
Supporting the development of professional competence:
Unconscious incompetence
Conscious incompetence
Conscious competence
Unconscious competence
Learner characteristics:
Low level of competence Unaware of failings
Low level of competence. Aware of failings but not skills to correct them
Demonstrates competence but skills not fully internalized or integrated. Has to think about activities
Carries out tasks without conscious thought. Skills internalized and routine. Little or no conscious awareness of detailed processes involved in activities
Clinical Educator role:
Supportively helps learner to recognize weaknesses identify areas for development and become aware of learning or development needs and thus conscious of ‘incompetence’
Uses range of skills and techniques, to assess learners’ development in relation to defined expectations for the level and stage of learning. Helps learner to develop and refine self- assessment skills. Reassures and supports
Helps learner to develop and refine skills, reinforces good practice and competence through positive regular feedback and a focus on areas for development and refinement of skills, additional knowledge required and integration of competences
Raise awareness of detail and unpack processes for more advanced learning, help learner to identify any areas of weakness or bad habit that he/she may not be aware of
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The Continuum of Learning
The CE’s role can be seen as inversely proportionate to the student’s role as the externships
progress over time. The CE develops from Educator to Sponsor as the student becomes more
independent over the course of the 4 Externships.
As the CE and student relationship evolves, it is important not to maintain ongoing collaboration, a place where the roles meet and overlap.
Educating Coaching Sponsoring
When at the beginning of each externship
when introducing a
new procedure
when working with a new type of client
as the student gains clinical experience and skill
when the student is familiar with procedures and types of clients
at the end of the
final externship
How provide student with information, direct instruction, and modeling prior to sessions
provide student
with direct feedback regarding what went well during the session, what needs to be modified and how to make those modifications
encourage student to evaluate own sessions
engage in joint
problem-solving with student
encourage the student
to be innovative
expect and allow mistakes
encourage the student to make most decisions on their own
provide guidance
as requested by the student
act as a resource
Continuum of Learning: Initial → Transitional → Self-supervision
CE Rol S udent Rol
E u ating oa ing oa ing ont. Sp g
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Setting Expectations
Setting expectations with the student right from the beginning is an important step in fostering the student-
Clinical Educator relationship.
The following list can help ensure that you have all the points covered from the very first day:
Have you discussed:
1. The student’s perceived strengths? 2. Any current concerns? 3. Areas the student would like to develop? (*The Looking Ahead Form can facilitate this part
of the discussion, if the student has had previous externships)
4. How the student learns best? 5. The level of support the student feels they may need at this point? 6. Things that have worked/not worked before on placements? 7. The unique learning opportunities that your externship site provides?
The student’s expectations of the Clinical Educator, including but not limited to:
1. The frequency of one-to-one supervision sessions 2. Availability to be contacted as assistance is required 3. The best way to access advice on a day-to-day basis
The Clinical Educator’s expectations of the student, including but not limited to:
1. Punctuality 2. Procedures for absences 3. Willingness to share and participate (in both direct service work, as well as staff
interactions)
*The Clinical Skills Summary Form provide a summary of skills practiced and can facilitate the initial meeting
between Clinical Educators and students These are forms that are completed at the end of an externship;
Students are expected to bring this form on Day 1 of their Externship for discussion with the Clinical
Educator.
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Creating Learning Environments
Maslow’s hierarchy of needs for motivating learning (as cited in Hutchinson, 2003) suggests that for learners to
be truly successful, the external environments need to match the student’s intrinsic motivation to achieve and do
well.
The diagram below outlines the elements that are considered the “building blocks” of motivation. Each layer is
required before the ultimate goal of self-actualization can be reached.
What can you do to help?
What can you do to help?
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Clinical Educator Continuing Development
1. Your feedback style:
In order to deliver successful feedback, it is important for you to understand your own feedback style,
especially in relation to how your student receives feedback. This introspection will allow for clear
expectations from the very beginning of the externship.
Style A: You provide direct feedback in the form of telling, commenting etc., as well as actively listening to your students’ self-evaluations and comments, asking probing questions and “digging deeper”. You allow time for students to ask questions, as well as facilitating critical thinking and reasoning. Your students generally benefit from these sessions with you and change is often implemented immediately.
Style B: You provide direct feedback in the form of telling, commenting etc., but tend not to give as much time to your students’ self-reflections, their questions and/or comments. You find that your feedback has not always been interpreted accurately by your students, and frequent repetition is necessary
Style C: You are not entirely comfortable providing direct feedback to your students, and enjoy student-led discussions more. When initiated by the student, you give feedback in the moment, and enjoy probing further into the student’s experience. Your students feel comfortable to ask you questions, but may not always have a strong sense of areas that they need to improve, with goals that “miss the point”, or that tend to not be specific enough.
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2. Clinical Educator Self-Evaluation
Use the following check list to pinpoint areas of strength and weakness.
Overall Evaluation
I established clear expectations
I was responsive to the students’ learning styles
I incorporated the students learning agenda and objectives
I was readily accessible, given workplace limitations
I demonstrated enthusiasm for teaching
I demonstrated a caring attitude for clients and families
I demonstrated sensitivity to the needs of students
I took time for questions and discussion
I asked questions that stimulated problem-solving
I answered questions clearly
I explained my rationale for actions and decisions
I acknowledged when I did not know information and suggested
alternative sources to obtain information
I maintained an atmosphere that encouraged differing points of
view (i.e. open to ideas, suggestions and constructive feedback)
I provided regular, specific, constructive feedback
I promoted self-assessment and self-responsibility for learning
I shared my relevant knowledge and experience
I was an effective role model
I regularly corresponded with SASS re: successes and concerns
Follow up:
Are there areas that have been identified above that you would like further develop? Please let the CTCTeam know at the School, and this could be included as one or part of an upcoming webinar.
If you’d like feedback, you can have students complete the “Student Feedback on
Externship Experience” form that can be found in “Additional Resources”.
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Student Clinical Skill Development
Collaborative Practice
Clinical Reasoning
Feedback Conversation
Evaluations
Challenging Learning Situations
Facilitating Student Reflection
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Collaborative Practice: A tool for developing students’ skills through externships
Collaborative Practice is a process-oriented approach to clinical education.
Collaborative Practice is through guided observations and shared sessions, where the student moves
from being an observer of your practice, to sharing in that practice to practicing independently over
the course of their externship.
One such process is highlighted below through the depiction of the learning pathway that students
take through their externships. A student moves from a theoretical knowledge base to incorporating
and applying that knowledge in practical ways:
Knows: Student has the knowledge, gained through academic coursework. This is the foundation for
clinical practice.
Knows how: Student begins to understand how to apply knowledge to practice. This is acquired through
observations of Clinical Educator, and other peers.
Shows how: Student begins to demonstrate how to apply knowledge to practice. This is achieved through
the presentation of session plans and through shared sessions with Clinical Educators.
Does: Student actually applies theory to practice, highlighted through direct clinical contact with
clients.
Does
Shows how
Knows How
Knows
1 Miller's Pyramid (as cited in Norcini, 2003)
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Clinical Reasoning
Another way of facilitating students’ growth through the [knows → knows how → shows → does] process is the
development of clinical reasoning.
As a Clinical Educator, making explicit your own actions and your rationale behind those decisions is
often the first step in helping a student along this continuum. We can take for granted how “routine”
some of our clinical tasks and hypotheses have become. What seems obvious to an experienced
Clinical Educator has often left a student stumped!
As a student, making explicit your own thought processes can also be helpful. There are certain
question strategies that can be used by both Clinical Educators and students to elicit different
responses, stimulate deeper thinking and reflection, and promote critical thinking and discussion
such as:
Evidence
- How do you know that? - What evidence is there to support that position?
Clarification
- Can you put that another way? - Can you give me an example? - Can you explain that term?
Explanation
- Why might that be the case? - How would we know that? - Who might be responsible for…?
Linking and extending
- Is there any connection between what you have just said and what Y said earlier?
- How does this idea support or challenge what we explored earlier in the session?
Hypothetical
- What might happen if? - What would be the potential benefits of X?
Cause and effect
- How is this response related to management? - Why is or isn’t Treatment X suitable in this condition? - What would happen if we…?
Summary and synthesis
- What remains unsolved or uncertain? - What else do we need to know or do to understand this better or be better
prepared? (Adapted from Brookfield, 2006, Discussion as a way of teaching).
“I don’t know” are three incredibly important words. They are the beginning of the learning process
for clinicians and students alike. Setting the above questions in a safe and important environment is
vital to success.
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Clinical reasoning also develops overtime.
As a Clinical Educator, reflect on your own practice, and the steps you took from novice to expert.
How can this be broken down for a student?
1. Deductive Reasoning
(Novice)
Generation of hypotheses based on results. These hypotheses are then tested.
Frequently used by novices in all situations and experts during challenging or unfamiliar cases.
2. Inductive Reasoning
Quick retrieval of information from well- structured knowledge, based on clinical experience.
Frequently used by experts during familiar situations as they recognize patterns, or symptoms previously heard or experienced.
3. Narrative Reasoning
(Expert)
The client's experience and situation combined with the clinician's experience to facilitate the unfolding of the story.
Experienced clinicians; areas of practice where the complexity of the situation is critical to the outcome.
.
Written exercises such as decision trees can also be helpful for students, showcasing the information that is at their fingertips, whilst even more importantly, highlighting what they don’t yet know
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Feedback Conversation
The table below provides an example of a feedback conversation between a Clinical Educator and student (Cantillon & Sargeant, 2008). In this model, the student shares first, having had time to reflect post-session. The Clinical Educator responds and expands on what the student has shared, delving deeper if necessary. Following this, the Clinical Educator provides their own specific feedback to the student. It is suggested that the student make notes of this feedback, and prior to creating an action plan, the student reflects back their interpretation of what the Clinical Educator has shared. This solidifies mutual understanding and limits the risk of any miscommunication. The action plan is then created and agreed upon between Clinical Educator and student.
1. Student initiates discussion
This facilitates
the development of
the student’s self-evaluation
skills, promoting their
reflective learning
Clinician role Student role
NOTE: The students should have some time to reflect ahead of feedback session.
Student(s) should begin the discussion by self- evaluating their performance. This can be written and/or verbal. Students have access to a post session analysis form available to facilitate this reflection.
Structured questions can facilitate this process for students and provide a good starting point for ensuing discussion (See student post session analysis form):
1. What went well that you would do
again? Why?
2. What observations did you make
throughout the session? Based on these
observations, would you make any
adaptations to your original session
plan?
3. What would you like to change? How
will this change improve the outcome?
4. What would you not do again and why?
2. Clinician
follows up with
probing questions
This provides
the opportunity for the clinician
to go deeper into some of the areas of strength or weakness
The clinician can ask various probing questions, based on the student’s self- report. For example:
How did they feel during the
session?
How do they think the
patient felt? Why do they
think that?
What did they learn from the
session? Any critical
learning opportunities?
The student(s) will respond accordingly.
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3. Clinician
provides direct, specific
feedback to student
Direct feedback should be:
Constructive Objective Specific Timely
This can be given verbally, written or other
Additional thoughts and comments
Suggestions for future sessions can be discussed.
The student(s) can ask further questions here. The student(s) should repeat the feedback that they have interpreted to ensure accuracy.
Action Plan This should be initiated by the student, and agreed upon jointly.
The student(s) should have a clear plan of what to work on during the next session.
General feedback strategies:
Allow space for response and interaction in all feedback meetings.
Where possible, take a few minutes to do a general check-in with the student(s). This will
help gauge where the student is “at”. This in turn will facilitate the delivery of meaningful
feedback that can be processed by that that student in that moment.
Consider other sources for feedback – another peer, or a client can be useful sources.
Consider the methods of feedback you will employ: verbal, written, video, audio, direct,
indirect.
Try to limit your feedback to one or two points per session. This makes the feedback and
ensuing suggestion for change more actionable on the part of the student.
Deliberately seek the learners own perceptions of their performance
Ensure that feedback include discussion around how the student can apply the feedback to
practice.
Always include positive feedback – what is something that went well, or that you were
impressed by?
Remember you are always working at developing your students’ clinical reasoning skills: if a
student doesn’t know something that you are asking them, resist the temptation to give the
answer. Such gaps in knowledge can be homework, and revisited the next day.
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Evaluations
Process for Evaluation:
Tip 1: Plan this meeting early. Externships can fly by, and time is needed to both prepare and
participate in the evaluation conversation.
Tip 2: Both Clinical Educators and students may want to complete the evaluation form, both at
midterm and final. This provides insight for both parties alike.
Students have the opportunity to further develop their self-evaluation skills, while Clinical
Educators get a greater understanding of how the students believe they are performing.
Any discrepancy in ratings can be discussed by asking students to provide rationale or examples of behaviours/skills they believe they have demonstrated for the items rated, and aligning this with
the Clinical Educator’s rationale. This shared process ensures rich conversation, involving both
Clinical Educators and students equally.
NOTE: While the process of collaborative evaluations are recommended, it is important to understand that final grades are still awarded at the discretion of the Clinical Educator and these
grades are not to be considered negotiable by students.
1. Midterm Evaluation:
Midterm evaluation is a formative evaluation tool – it provides a point in the externship to examine the development of skills so far, while creating a learning pathway in order to move forward.
Formative evaluation supports feedback and the application of that feedback to effect improvement
at the next stage of learning.
The Clinical Coordinators at the School use this tool as a means of checking in with both the Clinical
Educator and the student, identifying areas of strengths as well as items that may become a
challenge.
2. Clinical Action Plans:
These are completed as part of the midterm evaluation –they list the goals for the remainder of the
placement, as well as strategies to achieve each goal. These are created in collaboration with the
student and are also sent to the Clinical Coordinator at the School.
Studomple
self- evaluation
Clinical Educatoromple
evaluation
Collabo a ivalua ion
discussion
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3. Final Evaluation
Final evaluation is a summative tool – it is a culminated result, and provides a rating that the
student requires in order to move on through the program, and ultimately to graduation. The final
evaluation of any clinical externship should be based on the last 20% of that externship.
Evaluation rating scale: What do the numbers stand for?
7 acquired skill; proficient and independent in applying skill; entry level clinician
6 nearly acquired skill; present >75% of time; student arrives at solutions/alternatives following only general discussion with Clinical Educator
5 developing skill; student arrives at solutions/alternatives following Clinical Educator's prompting questions; student carries through effectively
4 developing skill; student arrives at solutions/alternatives following Clinical Educator's prompting questions; student carries through needing additional guidance
3 emerging skill; clinician provides solutions/alternatives; student carries through needing additional guidance
2 emerging skill; Clinical Educator provides specific direction and demonstration; student carries through needing additional guidance
1 skill not evident; specific direction and demonstration does not alter performance or alters marginally
NA no or insufficient opportunity to evaluate
Grading students along the continuum of externships – what can you expect to be the average rating at the end of every externship?
*Please note that these are averages and ratings should be given at the discretion of the Clinical
Educator.
A age
In order to pass, the student must achieve at least an average of 3, with no individual item scores of 1
A age -
In order to pass, the student must achieve at least an average of 3, with no individual item scores of 1
A age
In order to pass, the student must achieve at least an average of 4, with no individual item scores less than 3
A age -
In order to pass, the student must achieve at least an average of 5, with no individual item scores less than 4
Externship 1
Externship 2
Externship 3
Externship 4
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The Challenging Learning Situation - What to do and when
Some signs that students may be struggling:
1. Student is defensive to feedback ☐
2. Student is not effectively time managing ☐
3. Student appears tired/low energy☐
4. Student appears anxious/worried ☐
5. Student is having difficulty applying feedback ☐
6. Student lacks insight and awareness ☐
When to be concerned? When/if the problems interfere with performance
Types of Problems Encountered:
Define the problem where possible:
Knowledge/Skill?
Personal Nature
(e.g. illness, stress)?
Interpersonal skills?
Can it be solved by:
1. Clarifying communication styles between you and the student?
2. Creation of an Education Plan?
3. Adjusted expectations?
4. Renegotiated learning objectives?
5. Bringing in another party e.g. Clinical Coordinator?
What if the problem persists, in spite of your guidance and feedback? 1. Contact one of the
Clinical Coordinators
for discussion and
support
2. Plan of action with student
and Clinical Coordinator may
be redefined
3. Externship may be
modified,
responsibilities
redefined
4. Student may need
to withdraw from
externship
Please contact the Clinical Coordinator as soon as possible to ensure the best possible outcome for you and your student
What is the Externship Modification Process?
Three steps:
1. Remediation
When: If student’s performance is unsatisfactory, as determined by Clinical
Coordinator in consultation with Clinical Educator. Ideally, weaknesses identify
by mid-term evaluation or sooner.
Who: Clinical Coordinator, in consultation with Clinical Educator and Student.
What: Written action plan developed for student to include learning objectives,
learning strategies, time frame and evidence of accomplishment. Plan signed by
CC, CE and SC.
2. Probation When: If student does not meet goals for remediation and/or pass practicum at expected level. Who: Probation Committee
What: Appropriate next steps will be determined: 1. Probationary period 2. Extended program 3. Exiting program
3. Immediate Termination of Clinical Externship
Who: Director of Program
What: The director will meet with the student to discuss decision and its
rationale.
For further information, please read our Policy Addressing Unsatisfactory
Performance in Clinical Externships
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Facilitating Student Reflection: Some ideas Other than reflecting on their performance in client sessions, students can be encouraged to reflect on the learning opportunities listed below. This list is not definitive and other areas for reflection can be suggested by both the Clinical Educator, and the student alike.
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Forms Midterm Evaluation
Final Evaluation: Evaluation of Clinical Skills in Audiology
Summary of Clinical Hours Form
Looking Ahead
Clinical Skills Summary Form
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tio a d B mpl th ating al .
Grading:
NOTE: If a rating is obtained of “I” or “U” (Section A) or ratings predominantly at or below “A” for “Progress slow but acceptable” (Section B), please notify the Clinical Coordinator immediately.
MIDTERM EVALUATION
Instructions for Completion:
Halfway through the placement, a broad review of progress is required. When completing the Midterm Evaluation, the final evaluation form may be used as a guide. The mid-term evaluation matches the areas described in detail in the final evaluation, but is intended to be a more general assessment of how the student is progressing given opportunities to observe, practice and receive feedback. Goals are set for the remainder of the externship.
The mid-term is divided into three sections:
A. Requirements for Professional Practice B. Skill Development Evaluation C. Goal Setting For Remainder of Externship
Section C: Create goals for the remainder of the externship.
Together, the Clinical Educator and the student clinician identify goals within specific skill areas, and brainstorm strategies for achieving these goals during the remainder of the placement. Goals may be prioritized.
Goals: 1. focus on specific skills that require practice for continued development 2. develop specific areas where weaknesses are identified 3. even out development across the continuum of clinical skills 4. provide steps aimed at developing more advanced clinical skills, where strengths are identified.
Goals may include interpersonal and professional abilities, as well as assessment, treatment, and communication skills. Broader domains for development, such as problem solving and self- evaluation may cross more than one skill area.
Strategies: Strategies are the specific steps that will be most effective in achieving a goal. Strategies are developed collaboratively between Clinical Educator and student, and specify the role that each person will take.
Please review the Clinical Action Plan on a weekly basis in order to ensure progress towards goals.
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MIDTERM EVALUATION
Student’s Name: _Site:
A. Requirements for Professional Practice: The following characteristics are basic requirements for success in the workplace.
Rate the following five items as (S) Satisfactory (I) Inconsistent, or (U) Unsatisfactory 1. Preparation for all clinical assignments 2. Punctuality 3. Confidentiality 4. Professional appearance 5. Language appropriate to professional setting
B. Skill Development Evaluation:
Rating key:
! = A particular strength for this student = Progress as expected
A = Progress slow but acceptable C = Progress minimal, and of concern
U = Unsatisfactory performance N/A = Insufficient opportunity to evaluate
1. Interpersonal and
Professional Skills Relates to client, client’s family
Interacts with Clinical Educator, other professionals
Evaluates own professional knowledge and limits
Participates as a team member
2. Assessment Skills Plans and prepares for assessments
Implements appropriate assessment procedures
Makes accurate clinical impressions
Makes appropriate recommendations/referrals
3. Amplification and Rehabilitation Skills
Determines goals and objectives
Plans and prepares prior to treatment sessions
Manages sessions as they are in progress
Forms accurate clinical impressions and adjusts treatment plans accordingly
4. Communication Skills Oral communication
Written communication
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C. Goal Setting for the Remainder of the Externship
Identify 3-4 specific goals to focus on clinical skill development for the remainder of the placement. The focus may be: any gaps in clinical experience so far, any areas to build independence or any special opportunities specific to your site. Include specific strategies and actions needed to support skill development.
1. AREA:
GOAL:
STRATEGIES:
2. AREA:
GOAL:
STRATEGIES:
3. AREA:
GOAL:
STRATEGIES:
4. AREA:
GOAL:
STRATEGIES:
Clinical Educator(s) Name(s) ___________________
Clinical Educator(s) Signature(s) _______________
Student Extern Signature DATE:
PLEASE SUBMIT MIDTERM EVALUATION to CLINICAL COORDINATOR
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SCHOOL OF AUDIOLOGY AND SPEECH SCIENCES Faculty of Medicine
University of British Columbia 2177 Wesbrook Mall
Vancouver, B.C. V6T 1Z3 Fax: 604-822-6569
EVALUATION OF CLINICAL SKILLS IN AUDIOLOGY
This evaluation is a means of charting the development of clinical skills over the course of several externships, as well as a means to measure the level of independence in clinical skills at the end of a placement. Development of clinical skills is based on the development of both knowledge (i.e., knowing about disorders and about clinical procedures) and clinical performance (i.e. the ability to apply this knowledge effectively). The scale is as follows, with 7 representing the skills of an entry level clinician.
Rating Scale:
7=acquired skill; proficient and independent in applying skill; entry level clinician
6=nearly acquired skill; present >75% of time; student arrives at solutions/alternatives following only general discussion with Clinical Educator
5=developing skill; student arrives at solutions/alternatives following Clinical Educator's prompting questions; student carries through effectively
4=developing skill; student arrives at solutions/alternatives following Clinical Educator's prompting questions; student carries through needing additional guidance
3=emerging skill; clinician provides solutions/alternatives; student carries through needing additional guidance
2=emerging skill; Clinical Educator provides specific direction and demonstration; student carries through needing additional guidance
1=skill not evident; specific direction and demonstration does not alter performance or alters marginally
NA=no or insufficient opportunity to evaluate Tear this sheet off for quick reference
UBC School of Audiology and Speech Sciences 35
GRADING EXPECTATIONS FOR EACH PLACEMENT
A. Requirements for Professional Practice
Students are expected to achieve a rating of “Satisfactory” for each item in this section. If an “Inconsistent” or “Unsatisfactory” rating appears on the final evaluation, the student’s grade for the externship will be lowered unless there are extenuating circumstances.
B. Skill Development Evaluation
Externship 1: An average of all items scored should result in a typical average score of 4 To Pass*, a student must achieve at least an average of 3 with no individual item scores of 1
Externships 2: An average of all items scored should result in a typical average score of 4 - 5 To Pass*, a student must achieve at least an average of 3.5 with no individual item scores of 1
Externship 3: An average of all items scored should result in a typical average score of 5 To Pass*, a student must achieve at least an average of 4 with no individual item scores less than 3
Externship 4: An average of all items scored should result in a typical average score of 6-7 To Pass*, a student must achieve at least an average of 5.3 with no individual item scores less than 4
* a “Pass” is equivalent to a “C+” for Externships 1 to 3 and a B- for Externship 4. Of the 4 major externships, a student may not have more than one “C+” score, and it may not occur in Externship 4. If an externship is failed, the hours accumulated will NOT count toward the student’s total number of clinical hours.
Instructions for Completion: 1. Base your evaluation on the student's performance during the last 20% of the externship.
2. Complete the form and review with the student a day or two before the end of the externship.
3. Specific skills should be rated only if the student has had adequate opportunity to develop ability in this area. For example, if the student had two opportunities to complete an assessment, than this section should not be rated.
Tear this sheet off for quick reference
UBC School of Audiology and Speech Sciences 36
Faculty of Medicine Univ
Student: Dates: From To:
# of Days Absent
Externship #: 1 2 3 4
Site:
Clinical Educator(s):
B. Requirements for Professional Practice
The following characteristics are basic requirements for success in the professional workplace:
Satisfactory (S) Inconsistent (I) Unsatisfactory (U)
1. Is adequately prepared for sessions
2. is punctual with respect to appointments, meetings and clinical assignments
3. respects confidentiality of all professional activities
4. presents a professional appearance
5. uses appropriate voice, speech and language
Evaluation of Clinical Skills in Audiology
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C. Skill Development Evaluation
1. Interpersonal and Professional Skills: N/A 1 2 3 4 5 6 7
1. relates comfortably to the client and client's family
2. accurately observes and interprets verbal and non-verbal behaviour
3. effectively manages behaviour of client and client's family
4. is responsive to issues and concerns raised by client and family
5. demonstrates flexibility in adjusting to different people/situations
6. is open and responsive to direction/suggestions from the Clinical Educator
7. requests assistance from Clinical Educator and other professionals when appropriate
8. presents an appropriately confident manner
9. recognizes own strengths and weaknesses and professional limits
10. works cooperatively and supportively as a team member
Comments:
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2. General Clinical skills: N/A 1 2 3 4 5 6 7
1. applies theoretical knowledge to the assessment process
2. establishes a rapport with clients
3. gathers relevant case history information
4. uses the client files and case history information to plan appropriate sessions
5. determines appropriate recommendations and/or referrals based on all available data
6. uses time effectively for client appointments and for other clinical tasks and learning opportunities
Comments:
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3. Basic Diagnostic Audiology: N/A 1 2 3 4 5 6 7
1. gives clear instructions
2. is familiar with equipment and trouble shoots simple problems
3. conducts Pure Tone Audiometry (A/C, B/C)
4. conducts reliable Speech Audiometry
5. recognizes when to mask
6. utilizes proper masking techniques
7. performs immittance measurements
8. performs otoacoustic emissions testing
9. performs and reports on basic otoscopic examinations
10. interprets results of basic test battery in relation to history; communication skill; medical findings
Comments:
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4. Diagnostic Pediatric Audiology N/A 1 2 3 4 5 6 7
1. Manages the environment and tests to maintain child’s interest
2. selects tasks and stimuli appropriate to level of child
3. makes appropriate observations of auditory behaviours
4. performs Visual Reinforcement Audiometry (VRA)
5. performs Play Audiometry
6. performs Speech Audiometry
7. performs other tests: Please Specify
8. gets most pertinent information when complete testing is not possible
9. interprets results of test battery in relation to history, communication ability and medical findings
Comments:
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5. Electrophysiologic and Other Audiologic Tests N/A 1 2 3 4 5 6 7
1. Non-organic hearing loss assessment: a) Identifies when tests are indicated b) Selects appropriate test battery c) Administers appropriate tests
2. Evoked potential tests: a) Identifies when tests are indicated b) Selects appropriate test battery c) Administers tests
3. CAPD assessment (Specify tests:_______________________________) a) Identifies when special tests are indicated b) Selects appropriate test battery c) Administers tests
4. Special populations (Specify:__________________________________) a) Identifies when tests are indicated b) Selects appropriate test battery c) Administers tests
5. Adapts protocol/parameters for special situations
6. Interprets overall test profile
Comments:
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Amplification N/A 1 2 3 4 5 6 7
1. Identifies client needs based on all pertinent data
2. Makes appropriate recommendations for communication management (counseling, amplification, group classes, FM systems, hearing assistive technology_
3. Generates appropriate fitting targets
4. Shows facility work with NOAH and manufacturers’ modules
5. Selects appropriate amplification features and options
6. Shows facility in programming amplification
7. Performs electroanalysis of hearing aids
8. Administers real ear measurements
9. Does troubleshooting and listening checks of amplification
10. Takes ear impressions
11. Chooses and performs appropriate earmold modifications
12. Assesses classroom needs if applicable
13. Conveys information on care and use of amplification effectively
Comments:
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Aural (Re)habilitation This section applies to either individual or group situations
N/A 1 2 3 4 5 6 7
1. Establishes and maintains effective therapeutic relationship with client and/or significant other(s)
2. Identifies and effectively communicates appropriate communication strategies
3. Conveys information on adjustment to amplification and realistic expectations
4. Determines realistic long range goals for treatment which are appropriate for client’s needs
5. Applies effective teaching techniques in classroom situations
6. Determines when to discontinue treatment
Comments:
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Additional Comments:
Clinical Educator Name: _________________________ Clinical Educator Name: _________________________
Clinical Educator Signature: _______________________ Clinical Educator Signature: ________________________
Student Clinician's Signature: ______________________ Date of Evaluation ________________________
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Summary of Clinical Practice Hours
UBC School of Audiology and Speech Sciences 46
LOOKING AHEAD Goals & Ideas for the Next Placement
Clinical Educator and Student Clinician: Please complete this form at the end of the externship for the student to take to the next placement.
Student’s Name:
Current Placement:
Current Caseload: _
1. Description of Clinical Experience:
2. Strengths:
3. Areas for Further Development:
4. Learning Style:
UBC School of Audiology and Speech Sciences 47
SCHOOL OF AUDIOLOGY AND SPEECH SCIENCES 2177 Wesbrook Mall Faculty of Medicine Vancouver, B.C. V6T 1Z3 University of British Columbia Tel: (604) 822-5591 Fax: (604) 822-6569
Student Clinician:
Clinical Skills Summary Form - Audiology
Instructions: Please complete before each externship and give it to your CE with the “Looking Ahead” form on your first day of clinic.
Clinical Experience Location/site Client population
Practicum 1 Dates:
Practicum 2 Dates:
Practicum 3 Dates:
Practicum 4 Dates:
History I have not done this yet in the clinical setting
I have done this 1 or 2 times but still need support
I can do this independently
Review client chart
Take a case history
Other:
Comments:
Behavioural Assessment I have not done this yet in the clinical setting
I have done this 1 or 2 times but still need support
I can do this independently
Unmasked puretone audiometry Masked puretone audiometry
Play audiometry
Visual Reinforcement Audiometry
Speech reception thresholds
Word Recognition Score
Masking for speech testing
Other:
Other:
Comments:
UBC School of Audiology and Speech Sciences 48
Electrophysiologic assessment I have done this yet in the clinical setting
I have done this 1 or 2 times but still need support from my CE
I can do this independently
Tympanometry
Acoustic reflex thresholds
Acoustic reflex decay testing
Otoacoustic emissions
Neurological ABR
Threshold ABR
Other:
Comments:
Hearing Aids I have not done this yet in the clinical setting
I have done this 1 or 2 times but still need support
I can do this independently
Identify when a client may benefit from amplification
Determine hearing aid options based on assessment data
Present hearing aid options to the client
Take ear impressions
select appropriate features and options
Program hearing aids in NOAH
Perform electroacoustic analysis of hearing aids
Administer real ear measurements
Conduct a hearing aid listening check
Troubleshoot hearing aids and do basic in-house cleaning and repairs
Select appropriate earmold styles
Earmold modifications
Provide an orientation session for client with new hearing aids
Set up and demonstrate wireless accessories
Set up an FM system including FM matching
Other:
Comments:
Aural Rehabilitation I have not done this yet in the clinical setting
I have done this 1 or 2 times but still need support
I can do this independently
Identify and teach communication strategies
Convey information on adjustment to amplification and realistic expectations
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Determine long range goals and set up a treatment plan
Teach an aural rehabilitation class
Other
Comments:
Written Communication I have not done this yet in the clinical setting
I have done this 1 or 2 times but still need support
I can do this independently
Full narrative assessment report
Section(s) of narrative assessment report
Letter of referral to another professional
Maintain client session records
On-line charting in client file
Other
Comments:
Oral Communication I have not done this yet in the clinical setting
I have done this 1 or 2 times but still need support
I can do this independently
Review assessment results with client, family or team member
Review treatment progress with client, family or team member
Participate in team rounds or meetings (i.e. provide client update)
Other
Comments: Specialized tests I have done this
yet in the clinical setting clinical setting
I have done this 1 or 2 times but still need support
I can do this independently
Vestibular:
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CAPD:
Cochlear Implant:
Other:
Comments:
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Additional Resources Curriculum Overview, Audiology Students
Getting set up. Who does what when
Student Post Session analysis
Clinical Feedback Form
UBC School of Audiology and Speech Sciences 52
Curriculum Overview, Audiology Students
What have students covered in their academic coursework by the time they begin their
externship with you?
Below you will find the various courses and the terms in which they are taught. Brief descriptions of the key-
learning areas for each course, as well as the student learning outcomes have been included for your reference.
Year 1, Term 1 September to December
Course title Description:
Hearing Sciences I
Key learning areas: physical acoustics, auditory physiology and auditory perception/psychoacoustics. Students will: apply concepts about auditory structure, function and perception to natural listening or clinical scenarios, in order to explore aspects of hearing for both individuals with normal hearing and individuals with a hearing loss
Articulatory and Acoustic Phonetics
Key learning areas: phonetic sciences for improving, among other things, speech recognition by people with a hearing loss Students will: apply concepts about sound level, octaves filters and digital signal processing to the acoustic analysis of speech sounds. Includes a focus on speech development in deaf and hard of hearing children.
Fundamentals of Audiology
Key learning areas: the significance of hearing loss on human communication and interpersonal relationships, the impact Audiologists have on deaf and hard-of-hearing individuals and community Students will: conduct an audiological assessment (including masking), as well as being made aware of habilitation and rehabilitation approaches in Audiology
Research Methods I Key learning areas: research and clinical practice within the field of communication sciences and disorders. Students will: demonstrate basic knowledge of: i. The scientific method and evidence based practice ii. Basic statistical concepts and theories. iii. Commonly used research designs. iv. How to critically evaluate research. v. Systematic evaluation of the reliability and validity of assessment procedures, and of treatment efficacy
Communication Development and Disorders
Key learning areas: theoretical underpinnings of clinical practice, and approaches and procedures for assessment and intervention with a specific focus on children. Students will: understand principles of language assessment and intervention based upon a developmental-descriptive model and research with language disordered children, assessment planning and assessment procedures for meeting various goals, principles for developing well- designed intervention activities, current approaches to language intervention based on research evidence, adapting assessment and intervention for clients form different linguistic and cultural backgrounds.
Adult Language Development
Key learning areas: sensory, language and cognitive systems as adults get older, focusing particularly on how these changes impact communication Students will: learn about bilingual language development, key concepts, theoretical issues, models and themes that are relevant to understanding normal and impaired language use at any age
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Year 1, Term 2 January – April
Course Title Description
Hearing Science II
Key learning areas: advanced physiological aspects of a healthy and impaired cochlea; the efferent auditory system; brainstem processing of binaural stimuli; and auditory plasticity. Students will: understand the physiologic mechanisms and clinical application of (i) electrocochleography, (ii) human cortical responses, and (iii) otoacoustic emissions
Aural Rehabilitation
Key learning areas: characteristics of hearing impairment, the effects of hearing loss on individuals of all ages and the principles of aural rehabilitation for infants, children and adults. Basic principles of counseling and the specific counseling skills needed in the practice of Audiology will also be introduced. Additionally, the principles of treatment for tinnitus will be discussed.
Students will: Describe the demographics of hearing loss, the elements of a comprehensive aural rehabilitation model. Explain the effects of hearing loss on the communication skills of infants, children and adults including the psychological, social and emotional effects of hearing loss across the lifespan. Describe and discuss appropriate tools for assessment of auditory skills for individuals of all ages and abilities • Explain different approaches for intervention for hearing loss including visual modes of communication. Describe the basic principles of counseling
Diagnostic Audiology 1
Key learning areas: The primary focus of this course is pure-tone and speech audiometry including masking, immittance measures, and administration and interpretation of audiological tests for diagnosis of hearing loss and/or impairment of the auditory system for infants, children and adults. Additional topics to be covered include: causes of hearing loss, instrumentation and calibration, case history taking, reporting, and information counseling. Students will: 1. Perform a standard audiometric test battery. 2) perform counselling retarding results for children and adults 3) Explain calibration and hygiene procedures for maintaining audiological equipment 4) perform hearing threshold estimation using behavioural pure-tone audiometry techniques suitable for infants and young children including VRA and conditioned play audiometry. 5) perform word recognition assessments in infants and children 6) Describe relevant etiological, and medical causes of hearing loss 7) Recognize common auditory disorders 8) explain underlying causes and principles of tinnitus and describe appropriate protocols for assessment of tinnitus in adults 9). Describe and apply ethical considerations and professional issues and their impact on assessment and treatment of individuals with hearing deficits
Amplification 1
Key learning areas: Understand what hearing aids are and what they can do (up to current day Students will: Take earmold impressions; Troubleshoot hearing aid malfunction; Know how to use the equipment and tools available for hearing aid measurement
Physiological Measurement of Auditory Function
Key learning areas: auditory evoked potentials, with particular emphasis on the auditory brainstem response and, to a lesser extent, the auditory steady-state responses (ASSR). Students will: (i) understand principles of averaging and detection (visual, statistical) of evoked potentials (ii)understand rationales underlying selection of various recording/stimulus parameters for auditory evoked potentials (iii) become familiar with basic issues of ABR and ASSR (iv) understand issues concerning calibration of brief-duration stimuli used to elicit ABR and ASSR (v) become familiar with newborn hearing screening (vi)know basics of clinical auditory evoked potential protocols (vii) be able to carry-out basic clinical ABR (click- and tone-evoked) tests (viii) know basics of clinical interpretation of auditory evoked potential tests, especially ABR, and (ix) understand appropriate and inappropriate uses for various auditory evoked potential tests for clinical use.
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Year 2, Term 1 September to December Course title Description
Research Methods II
Key learning areas: principles of responsible conduct of research (basic and clinical) Students will: be able to critically evaluate longitudinal and single-subject research designs, as well as a meta-analysis or a systematic review.
Diagnostic Audiology II
Key learning areas: special auditory tests involved in the differential diagnosis of aural pathologies including APD, Vestibular assessments and advanced middle ear analysis. Students will: identify and understand current issues in assessment of auditory processing disorders, describe the comprehensive auditory processing screening process and select appropriate test battery for the target population. Interpret vestibular assessment techniques and interpret and conduct advanced middle ear analysis techniques in different populations.
Amplification II
Key learning areas: advanced concepts related to hearing instrument fittings: Assessment, Selection and Verification, and Outcomes (Validation). Students will: describe in detail the steps of hearing aid fitting, determine candidacy for advanced and complex cases, assess individual patient characteristics and develop guidelines for matching technology to individual patients including pediatric clients. Perform advanced repairs and maintenance on hearing instruments.
Issues in Professional Practice
Key learning areas: effective and self-aware communication, constructive approaches to conflict and interpersonal and intra-professional team skills, topics related specifically to clinical practice e.g. report writing, goal- setting, counselling skills Students will: write SMART/SMARTER goals, be introduced to charting, report writing and online data collection , understand the Audiology scope of practice and the Audiologist’s role in counselling in communication disorders, be exposed to conflict management styles and professional communication
Pediatric Audiology
Key learning areas: Management of hearing loss in infants and young children Students will: explain causes of hearing loss in infants and young children, provide appropriate counselling support to families with children with hearing loss, explain current issues regarding the diagnosis and management of (central) auditory processing disorders, apply principles of case management for school aged children with hearing-related disorders.
Hearing and Noise
Key learning areas: noise hazard, noise measurement and noise induced hearing loss and its prevention. Students will: explain the significance of noise in occupational and community settings, interpret noise data and noise surveys, design a Hearing Conservation Program
Cochlear Implants
Key learning areas: overview of cochlear implants and related technologies. The neuroscience basis for electrical stimulation of the ear, cochlear implant candidacy. Students will:
Approaches to Audiology and SLP for Aboriginal People in Canada
Key learning areas: First Nations, Métis and Inuit heritage and culture, culturally sensitive interaction and practice styles for clinicians Students will: develop an awareness of identity and location of oneself in relation to people of Aboriginal heritage in Canada and begin to consider approaches to audiology and speech-language pathology for people of First Nations, Metis and Inuit heritage
Hearing and Aging
Key learning areas: anatomical and physiologic effects of aging, assessment and management Students will: differentiate the concepts of normal aging and disease, describe age-related changes in the auditory system, explain assessment considerations and tailor rehabilitation programs for older adults, develop strategies for working with vulnerable older adults.
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Getting set up: Who does what when?
A. Pre-externship Training:
Provided by Clinical Coordinator at UBC For Clinical Educators
What Provide Clinical Educator with education re: the role of Clinical Educator, as well as
info re: goals for externships, externship processes and evaluations
Confirm externships and students attending the various sites
Individualized email and telephone support for all Clinical Educators
When Prior to commencement of Externship.
B. Pre-externship Introduction:
Provided by Student For Clinical Educators
What Provide Clinical Educator with letter of introduction, no later than one month
pre- externship
Contact Clinical Educator re: any preparation he/she might like you to undertake prior
to beginning of externship e.g. articles, assessments etc.
When Prior to commencement of Externship.
C. Pre-externship Preparation:
Provided by Clinical Educator For Students
What Provide student(s) with readings and/or information re: your clinical setting.
Take some time to consider what you as a clinician and your clinical setting can
uniquely provide the student during their externship. Use this to begin forming a
learning plan for your student.
Prepare your colleagues and clients for the arrival of your student
Ask whether this is your student’s first externship with children or adults – First Goals
Document (see Appendix) will need to be reviewed in this case
When Prior to commencement of Externship.
D. On-site Orientation
Provided by Clinical Educator For Students
What Provide physical overview of clinical setting
Coordinate team/staff introductions
Provide overview of caseload
Describe clinical organization and administration procedures (referral process, record
keeping, confidentiality)
Discuss expectations re the culture of the clinical setting:
Hours
Appropriate Dress
Lunchtime expectations
Outline Health and Safety/Emergency Procedures
When First day, if possible. No later than Week One.
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Student post-session analysis
(To be discussed with Clinical Educator)
1. What went well that you would do again?
i. Why?
2. What observations did you make throughout the session?
i. Based on these observations, did you make any adaptations to your original session plan?
3. What would you like to change? i. How will this change improve the outcome?
4. What would you not do again? i. Why?
UBC School of Audiology and Speech Sciences 57
Clinical Feedback Form This form may be used to provide comments and suggestions to the student following a session.
Date:
Client:
Activities:
that ou did well…
to tr ext time..
Goal(s) for ext ssion:
UBC School of Audiology and Speech Sciences 58